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HSE warns of risk from stroke drugs

Patients’ group calls for ‘consent forms’ after medication linked with haemorrhage

Prof Michael Barry, head of the HSE’s drug purchasing programme, said the medicines management programme was highlighting safety issues around two new treatments and other medications that were prescribed with them. Photograph: Brenda Fitzsimons

Consent forms should be introduced for patients receiving prescription medicines to ensure they are informed about their medication and possible side effects, the Irish Patients Association has said.

The organisation made its call following a warning to doctors about the prescribing of incorrect dosages of blood-thinning medications aimed at reducing the risk of stroke.

The HSE’s Medicines Management Programme (MMP) said almost 4,000 patients of more than 13,000 on new anti-coagulant drugs had either been prescribed too low a dosage of the medication or had been prescribed other medications which minimised or counteracted its effects.

Head of the HSE’s Drug Purchasing Programme Prof Michael Barry said the MMP was highlighting safety issues around two new treatments and other medications that were prescribed with them.

He said 16 per cent of patients were receiving too low a dose of the medication for it to have its intended effect, to prevent stroke.

At riskTwo new drug treatments were on the market and more than 13,000 patients were prescribed these medications. In 28 per cent of cases where patients were on the drug Rivaroxaban, there was an interaction with other medications that would make them slightly more susceptible to haemorrhage, Prof Barry said. Up to 37 per cent of all patients receiving long-term therapy with a second drug, Dabigatran, were at similar risk.

Stephen McMahon of the Irish Patients Association said they were pleased this information was being gathered but concerned about the quality of prescribing and the interaction with other medicines.

He said it “raises issues about doctors’ knowledge about what they are prescribing”.

It was now up to the medical profession to disseminate this information and to ensure patients were informed about their medicines and about the contraindications and how to recognise them, he said.

The association believes there should be a consent form for patients to sign when they receive their prescription to confirm they have been informed about their medication and associated risks.

Mr McMahon said “medicines can be as beneficial or as lethal as complex surgery. I’m not trying to frighten people but people trust doctors”.

Dr Darach Ó Ciardha, chair of communications of the Irish College of General Practitioners said: “GP prescribing of blood-thinning drugs would routinely be on the basis of hospital prescribing. A number of new blood-thinning treatments have come into use in the last number of years. The use of these drugs is initiated in hospitals. ICGP welcomes Prof Barry’s monitoring of these new medications in the interest of patient safety.”

An estimated 10,000 people suffer strokes in Ireland every year resulting in more than 2,000 deaths. Patients on the new drugs have been advised not to stop taking their medication but to contact their doctor if they have concerns.